Cargando…

Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues

Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follow...

Descripción completa

Detalles Bibliográficos
Autores principales: Albano, Giuseppe Davide, La Spina, Corinne, Pitingaro, Walter, Milazzo, Vanessa, Triolo, Valentina, Argo, Antonina, Malta, Ginevra, Zerbo, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866828/
https://www.ncbi.nlm.nih.gov/pubmed/36668788
http://dx.doi.org/10.3390/toxics11010062
_version_ 1784876188784656384
author Albano, Giuseppe Davide
La Spina, Corinne
Pitingaro, Walter
Milazzo, Vanessa
Triolo, Valentina
Argo, Antonina
Malta, Ginevra
Zerbo, Stefania
author_facet Albano, Giuseppe Davide
La Spina, Corinne
Pitingaro, Walter
Milazzo, Vanessa
Triolo, Valentina
Argo, Antonina
Malta, Ginevra
Zerbo, Stefania
author_sort Albano, Giuseppe Davide
collection PubMed
description Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follows the delivery, lasts up to 10 weeks, and requires intensive management. Therefore, the prevention and adequate management of NAS are relevant public health issues. This review aims to summarize the most updated evidence in the literature regarding toxicological, clinical, and forensic issues of intrauterine exposure to opioids to provide a multidisciplinary, evidence-based approach for managing such issues. Further research is required to standardize testing and to better understand the distribution of opioid derivatives in each specimen type, as well as the clinically relevant cutoff concentrations in quantitative testing results. A multidisciplinary approach is required, with obstetricians, pediatricians, nurses, forensic doctors and toxicologists, social workers, addiction specialists, and politicians all working together to implement social welfare and social services for the baby when needed. The healthcare system should encourage multidisciplinary activity in this field and direct suspected maternal and neonatal opioid intoxication cases to local referral centers.
format Online
Article
Text
id pubmed-9866828
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-98668282023-01-22 Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues Albano, Giuseppe Davide La Spina, Corinne Pitingaro, Walter Milazzo, Vanessa Triolo, Valentina Argo, Antonina Malta, Ginevra Zerbo, Stefania Toxics Review Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follows the delivery, lasts up to 10 weeks, and requires intensive management. Therefore, the prevention and adequate management of NAS are relevant public health issues. This review aims to summarize the most updated evidence in the literature regarding toxicological, clinical, and forensic issues of intrauterine exposure to opioids to provide a multidisciplinary, evidence-based approach for managing such issues. Further research is required to standardize testing and to better understand the distribution of opioid derivatives in each specimen type, as well as the clinically relevant cutoff concentrations in quantitative testing results. A multidisciplinary approach is required, with obstetricians, pediatricians, nurses, forensic doctors and toxicologists, social workers, addiction specialists, and politicians all working together to implement social welfare and social services for the baby when needed. The healthcare system should encourage multidisciplinary activity in this field and direct suspected maternal and neonatal opioid intoxication cases to local referral centers. MDPI 2023-01-09 /pmc/articles/PMC9866828/ /pubmed/36668788 http://dx.doi.org/10.3390/toxics11010062 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Albano, Giuseppe Davide
La Spina, Corinne
Pitingaro, Walter
Milazzo, Vanessa
Triolo, Valentina
Argo, Antonina
Malta, Ginevra
Zerbo, Stefania
Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title_full Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title_fullStr Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title_full_unstemmed Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title_short Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
title_sort intrauterine and neonatal exposure to opioids: toxicological, clinical, and medico-legal issues
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866828/
https://www.ncbi.nlm.nih.gov/pubmed/36668788
http://dx.doi.org/10.3390/toxics11010062
work_keys_str_mv AT albanogiuseppedavide intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT laspinacorinne intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT pitingarowalter intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT milazzovanessa intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT triolovalentina intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT argoantonina intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT maltaginevra intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues
AT zerbostefania intrauterineandneonatalexposuretoopioidstoxicologicalclinicalandmedicolegalissues